Neuromodulation Devices
Northwest DPC & Headache uses neuromodulation devices for both acute rescue as well as prevention for several types of headache, particularly migraine.
Neuromodulation may be appealing if you:
Want non-drug or low-systemic-side-effect options
Get side effects from common migraine medications
Need to limit triptans/NSAIDs to avoid medication-overuse headache risk
Want an add-on tool that pairs well with your current plan (rather than replacing everything)
Some people use devices primarily for acute attacks; others use them as a preventive routine (or both, depending on the device).
Neuromodulation devices
Cefaly
Cefaly is the first external trigeminal nerve stimulator approved by the FDA. This is worn on the forehead using an adhesive electrode; commonly used for prevention and sometimes acute treatment. Unfortunately this device is frequently cost prohibitive, but is available without a prescription.
FDA Approved: Migraine rescue and prevention
Practical Feel: A tingling/pulsing sensation that you can adjust, can be painful if select too high of a setting.
Best For: Individuals with migraine who want a device with significant amount of research and patient track record and who don’t have pacemakers/defibrillators, or seizure disorders.
HeadaTerm 2
HeadaTerm 2 is a newer external trigeminal nerve stimulator that doesn’t require a prescription. This device is also FDA approved, but doesn’t have as much proprietary research as Cefaly. However, it comes at a fraction of the cost and is usually much more feasible for cost conscious care.
FDA Approved: Migraine rescue & prevention
Practical Feel: A tingling/pulsing sensation that you can adjust, can be painful if select too high of a setting, but easier to prevent selecting too high of a setting by accident than Cefaly according to many patients.
Best For: Individuals with migraine who want a cost-conscious device and who don’t have pacemakers/defibrillators, or seizure disorders.
Nerivio
Nerivio (Remote Electrical Neuromodulation) is prescription-only wearable device placed on the upper arm that uses stimulation to activate pain-modulating pathways; used for acute and/or preventive treatment in migraine depending on device labeling and patient age. This is also approved for Cluster headaches and has evidence to support reducing pain during and after Botox for migraine.
FDA Approved: Acute and/or preventive Migraine or Cluster treatment
Practical Feel: Buzzing/tingling in the arm during a treatment session
Best For: People who want a discreet wearable, prefer not to stimulate the head/face, and like app-guided care. People who have migraine triggered after Botox administration.
GammaCore
GammaCore is a handheld prescription-only device applied to the neck for 2 minute increments; also used for both Migraine and Cluster headaches.
FDA Approved: Acute and preventive migraine
Practical Feel: A brief buzzing/stimulation on the neck during short treatment cycles
Best For: Patients who want an option that can cover more than one headache disorder (for example, migraine + cluster features).
Next Steps
If you’re considering neuromodulation, the best first step is a headache intake to confirm diagnosis, review your current regimen, and decide whether a device fits your plan.